280. Cancer Screening Flashcards
USPSTF Guidelines for Breast Cancer Screening
- what age group benefits most from screening?
Screening all W 50-74yo q2y
Individual decision W 40-49yo
- age 60-69 benefit most!!
Recommend AGAINST breast self-exam, insufficient evidence for clinical breast exam
USPSTF Guidelines for Cervical Cancer Screening
W 21-29yo q3y with pap smear alone
W 30-65yo q3y with pap smear alone OR q5y with pap smear + hrHPV testing OR q5y with hrHPV testing alone (only if still have cervix - not needed s/p hysterectomy)
Recommend AGAINST screening in W 65+ with normal screen w/in last 10y
USPSTF Guidelines for CRC Screening
- what tests are available and what is their frequency?
Start 45-49yo
Definitely do 50-75yo
Individual decision 76-85yo
Recommend AGAINST screening over age 85
No single test recommended over another
- FOBT q1y
- FIT (fecal immunochemical) q1y
- FIT-DNA q3y
- Colonoscopy q10y
- Sigmoidoscopy q5y
- CT Colonography q5y
USPSTF Guidelines for Lung Cancer Screening
ANNUAL screening with low-dose CT in adults 55-80yo with 30-pack-yr smoking hx AND either current smokers or quit w/in past 15yrs
USPSTF Guidelines for Prostate Cancer Screening
Individual decision 55-69yo for PSA
Recommend AGAINST screening over age 70
- due to overdx and high tx SE
What is cancer screening?
Procedure to detect a cancer or precancerous condition BEFORE SX DEVELOPMENT (pt has NO signs/sx of dz)
Define the following biases
- lead-time bias
- length-time bias
- compliance bias
How to avoid lead-time and length-time bias?
What is overdiagnosis bias?
Lead-time: dx cancer earlier, but do NOT delay death = perceived longer survival
Length-time: screening detects more indolent cancers (aggressive cancers avoid getting picked up on screening, due to faster mortality and sx development)
AVOID: by using cancer-specific mortality rates!!
Compliance bias: ppl who engage in screening are more compliant than general population
Overdiagnosis bias: screening detects cancer that would have remained subclinical before death from other causes (need cancer-specific mortality rates)
